| NPI | 1962922781 |
|---|---|
| Former Name | BETHANY MARY UNDERWOOD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036.152152) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036.152152) |
| Enumeration Date | 2017-06-22 |
| Last Update Date | 2021-11-29 |